From the Guidelines
Corticosteroids can cause constipation as a side effect, although the provided evidence does not directly link corticosteroids to constipation, it is essential to consider the potential gastrointestinal side effects of steroid treatment. Corticosteroids like prednisone, dexamethasone, and hydrocortisone may disrupt normal bowel function by altering fluid balance, slowing intestinal movement, and affecting electrolyte levels in the body, as seen in other contexts where gastrointestinal motility is affected 1. This is more common with higher doses and longer treatment durations. To manage steroid-related constipation, increase your fluid intake to at least 8-10 glasses of water daily, eat a high-fiber diet (25-30g daily) including fruits, vegetables, and whole grains, maintain physical activity, and establish a regular bathroom routine. Over-the-counter remedies like docusate sodium (100-300mg daily) or psyllium fiber supplements may help if dietary changes are insufficient, as suggested by guidelines for managing constipation in general 1. If constipation persists or becomes severe while taking steroids, consult your healthcare provider, as they may adjust your medication or recommend additional treatments.
Some key points to consider in managing constipation include:
- Increasing dietary fiber intake to the recommended daily amount of approximately 30g/d, as suggested by recent guidelines 1
- Consuming an adequate amount of fluids, particularly water, to help soften stools and ease bowel movements 1
- Using bulk-forming agents, such as psyllium husk or methylcellulose, which are safe to administer and can help promote regular bowel movements 1
- Avoiding stimulant laxatives, which can cause abdominal cramp and may lead to diarrhea and hypokalaemia with excessive use 1
It is crucial to prioritize the management of constipation to prevent potential complications and improve quality of life, especially in patients taking corticosteroids. The most recent and highest quality study suggests that a comprehensive approach to managing constipation, including dietary changes and appropriate use of laxatives, is essential for optimal outcomes 1.
From the Research
Corticosteroids and Constipation
- There is no direct evidence in the provided studies that corticosteroids cause constipation 2, 3, 4.
- The studies focus on the complications and side effects of corticosteroid therapy, such as avascular necrosis, gastrointestinal bleeding, and psychiatric syndromes 2, 3.
- One study mentions that long-term corticosteroid use may be associated with gastrointestinal effects, but it does not specifically mention constipation as a side effect 3.
- Another study discusses the side effects of corticosteroids in children, but it does not mention constipation as a potential side effect 4.
- A study on constipation in patients with neurological abnormalities does not mention corticosteroids as a potential cause of constipation 5.
- A study on the safety of Senna-based laxatives for long-term treatment of constipation in children does not mention corticosteroids at all 6.